The eardrum is essential for hearing because it senses sound waves and communicates the vibrations to the brain, but it also works as a barrier to seal off the inner ear and keep it free from infection. Whenever your eardrum is fully intact, your inner ear is a safe and sterile environment; but once it is punctured or torn, harmful bacteria have a way to get in and start a major infection called otitis media.

The phrases ruptured eardrum and perforated eardrum have the same meaning. They both describe a condition whose technical name is a tympanic membrane perforation in which there is a tear or puncture in the very thin membrane we know as the eardrum. A perforated eardrum can happen as the result of many causes, the commonest being an ear infection, which causes fluid to push up against the eardrum membrane and ultimately cause it to rip. Many people perforate their own eardrums by inserting foreign objects into the ears, for example the use of cotton swabs to eliminate ear wax. An additional frequent root cause is barotrauma – the problem that happens when the barometric pressure outside the ear is very different from the pressure inside the ear – which can occur while scuba diving or flying. Injuries to the head or acoustic trauma (such as sudden loud noises or explosions) can also tear the eardrum.

Symptoms of ruptured eardrums include:

• Pain in the ear
• Loss of hearing in the afflicted ear
• Vertigo or dizziness
• Fluid draining from the ear

A perforated ear drum should be examined and cared for by a doctor. Swift attention is vital to avoid infection and hearing damage. What you risk by not having these symptoms treated are major inner ear infections and cysts, and the chance of permanent hearing loss.

Punctured eardrums are diagnosed in a health care provider’s office using a tool called an otoscope, which has an internal light that allows the specialist to see the eardrum clearly. If your eardrum has been ruptured, generally it will heal itself within 8 to 12 weeks, but during this time period you should refrain from diving or swimming, avoid certain medications, and try to avoid blowing your nose (which would place more pressure on the already-damaged eardrum). If the puncture or tear is close to the edge of the eardrum, the doctor may help the healing process by inserting a temporary dam or patch to help reduce the risk of infection, or even suggest surgery.

Any remaining discomfort can be handled using over-the-counter pain medications such as ibuprofen or aspirin. Not every ruptured eardrum can be prevented, but there are things you can do to reduce your risk. Always get timely treatment for any ear infections and do not insert any foreign objects into your ear canal.